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Evans WD, Bingenheimer J, Cantrell J, Kreslake J, Tulsiani S, Ichimiya M, D'Esterre AP, Gerard R, Martin M, Hair EC. Effects of a Social Media Intervention on Vaping Intentions: Randomized Dose-Response Experiment. J Med Internet Res 2024; 26:e50741. [PMID: 38470468 DOI: 10.2196/50741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/12/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND e-Cigarette use, especially by young adults, is at unacceptably high levels and represents a public health risk factor. Digital media are increasingly being used to deliver antivaping campaigns, but little is known about their effectiveness or the dose-response effects of content delivery. OBJECTIVE The objectives of this study were to evaluate (1) the effectiveness of a 60-day antivaping social media intervention in changing vaping use intentions and beliefs related to the stimulus content and (2) the dose-response effects of varying levels of exposure to the intervention on vaping outcomes, including anti-industry beliefs, vaping intentions, and other attitudes and beliefs related to vaping. METHODS Participants were adults aged 18 to 24 years in the United States. They were recruited into the study through Facebook (Meta Platforms) and Instagram (Meta Platforms), completed a baseline survey, and then randomized to 1 of the 5 conditions: 0 (control), 4, 8, 16, and 32 exposures over a 15-day period between each survey wave. Follow-up data were collected 30 and 60 days after randomization. We conducted stratified analyses of the full sample and in subsamples defined by the baseline vaping status (never, former, and current). Stimulus was delivered through Facebook and Instagram in four 15-second social media videos focused on anti-industry beliefs about vaping. The main outcome measures reported in this study were self-reported exposure to social media intervention content, attitudes and beliefs about vaping, and vaping intentions. We estimated a series of multivariate linear regressions in Stata 17 (StataCorp). To capture the dose-response effect, we assigned each study arm a numerical value corresponding to the number of advertisements (exposures) delivered to participants in each arm and used this number as our focal independent variable. In each model, the predictor was the treatment arm to which each participant was assigned. RESULTS The baseline sample consisted of 1491 participants, and the final analysis sample consisted of 57.28% (854/1491) of the participants retained at the 60-day follow-up. We compared the retained participants with those lost to follow-up and found no statistically significant differences across demographic variables. We found a significant effect of the social media treatment on vaping intentions (β=-0.138, 95% CI -0.266 to -0.010; P=.04) and anti-industry beliefs (β=-0.122, 95% CI 0.008-0.237; P=.04) targeted by the intervention content among current vapers but not among the full sample or other strata. We found no significant effects of self-reported exposure to the stimulus. CONCLUSIONS Social media interventions are a promising approach to preventing vaping among young adults. More research is needed on how to optimize the dosage of such interventions and the extent to which long-term exposure may affect vaping use over time. TRIAL REGISTRATION ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668.
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Affiliation(s)
- William Douglas Evans
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Jeffrey Bingenheimer
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Jennifer Cantrell
- New York University School of Global Public Health, New York, NY, United States
| | | | | | - Megumi Ichimiya
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | | | - Raquel Gerard
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Madeline Martin
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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Behal R, Davis K, Doering J. A novel adaptation of spatial interpolation methods to map health attitudes related to COVID-19. BMC Proc 2023; 17:17. [PMID: 37461011 PMCID: PMC10351110 DOI: 10.1186/s12919-023-00264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic presented substantial challenges to public health stakeholders working to vaccinate populations against the disease, particularly among vaccine hesitant individuals in low- and middle-income countries. Data on the determinants of vaccine hesitancy are scarce, and often available only at the national level. In this paper, our goal is to inform programmatic decision making in support of local vaccine uptake. Our analytical objectives to support this goal are to (1) reliably estimate attitudinal data at the hyperlocal level, and (2) estimate the loss of data heterogeneity among these attitudinal indicators at higher levels of aggregation. With hyperlocal attitudinal data on the determinants of vaccine hesitancy, public health stakeholders can better tailor interventions aimed at increasing uptake sub-nationally, and even down to the individual vaccination site or neighborhood. METHODS We estimated attitudinal data on the determinants of vaccine hesitancy as framed by the WHO's Confidence, Complacency, and Convenience ("3Cs") Model of Vaccine Hesitancy using a nationally and regionally representative household survey of 4,922 adults aged 18 and above, collected in February 2022. This custom survey was designed to collect information on attitudes towards COVID-19 and concerns about the COVID-19 vaccine. A machine learning (ML) framework was used to spatially interpolate metrics representative of the 3Cs at a one square kilometer (1km2) resolution using approximately 130 spatial covariates from high-resolution satellite imagery, and 24 covariates from the 2018 Nigeria Demographic and Health Survey (DHS). RESULTS Spatial interpolated hyperlocal estimates of the 3Cs captured significant information on attitudes towards COVID-19 and COVID-19 vaccines. The interpolated estimates held increased heterogeneity within each subsequent level of disaggregation, with most variation at the 1km2 level. CONCLUSIONS Our findings demonstrate that a) attitudinal data can be successfully estimated at the hyperlocal level, and b) the determinants of COVID-19 vaccine hesitancy have large spatial variance that cannot be captured through national surveys alone. Access to community level attitudes toward vaccine safety and efficacy; vaccination access, time, and financial burden; and COVID-19 beliefs and infection concerns presents novel implications for public health practitioners and policymakers seeking to increase COVID-19 vaccine uptake through more customized community-level interventions.
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Affiliation(s)
- Raisa Behal
- Fraym, 3101 Wilson Blvd., Suite 300, Arlington, VA 22201 USA
| | - Kenneth Davis
- Fraym, 3101 Wilson Blvd., Suite 300, Arlington, VA 22201 USA
| | - Jeffrey Doering
- Johnson and Johnson, 1 Johnson and Johnson Plaza, New Brunswick, NJ 08933 USA
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Ichimiya M, Muller-Tabanera H, Cantrell J, Bingenheimer JB, Gerard R, Hair EC, Donati D, Rao N, Evans WD. Evaluation of response to incentive recruitment strategies in a social media-based survey. Digit Health 2023; 9:20552076231178430. [PMID: 37312941 PMCID: PMC10259135 DOI: 10.1177/20552076231178430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/10/2023] [Indexed: 06/15/2023] Open
Abstract
Objective This study aimed to examine varying incentives on acceptance to participate in an online survey on social media and to identify related demographic factors. Methods The study used Facebook and targeted its users aged 18 to 24 years in the United States. During recruitment, participants were randomized to one of the three types of incentives for survey completion, (1) a $5 gift card, (2) a lottery for a $200 gift card, and (3) a $5 gift card plus a lottery for a $200 gift card. Acceptance rates for survey participation were compared across three incentives using percentages, 95% logit-transformed confidence intervals, and Pearson's chi-squared tests. The survey asked about cognition and behaviors around smoking and vaping. Results The ads had 1,782,931 impressions, 1,104,139 reaches, and 11,878 clicks. The average ad frequency was 1.615, and the click-through rate was 0.67%. Males clicked less than females when seeing the ads. The acceptance rates for the three incentives were 63.7%, 37.2%, and 64.6%, respectively. A Chi-square test confirmed that the lottery-only group had a lower acceptance rate compared to those guaranteed an incentive, including the gift card group and the gift card and lottery group. Further analyses indicated that males did not opt into the survey as often as females when given the lottery-only incentive option, and those who did not meet their financial expenses opted into the survey more often than those who had more money than their expenses when given the lottery-only incentive option. Conclusions This study suggests that incentives guaranteed to all participants, even if the incentive's value is small, may lead to higher acceptance rates compared to a lottery for a greater incentive in social media-based surveys.
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Affiliation(s)
- Megumi Ichimiya
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | | | - Jennifer Cantrell
- Global Institute of Public Health, New York University, New York City, NY, USA
| | - Jeffrey B Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Raquel Gerard
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Global Institute of Public Health, New York University, New York City, NY, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dante Donati
- Marketing Division, Columbia Business School, New York, NY, USA
| | - Nandan Rao
- Universitat Autonoma de Barcelona, Catalunya, ES, Spain
- Barcelona School of Economics, Catalunya, ES, Spain
| | - W Douglas Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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A Digital Media Subscription Management System Combined with Blockchain and Proxy Re-Encryption Mechanisms. Symmetry (Basel) 2022. [DOI: 10.3390/sym14102167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The subscription economy was born because the relationship between creators and customers is different than it used to be. The era of the creator economy seems to be filled with boundless promise, but at the end of the day, creators are just slaves to tech giants. Neither the control of the content created, nor the money made in their pockets is in complete control of the creator. The blockchain can completely solve these injustices monopolized by enterprises. In the blockchain era, all kinds of creations from music, and video-to-text can be turned into assets that can be purchased and traded through smart contracts. In the music industry, for example, creators do not need to share profits with streaming platforms and record labels and get all the benefits directly. In addition, when the content created is on the chain, every transaction will be recorded on the blockchain, and everyone can inquire about it, avoiding opacity or causing disputes in the future. However, with the structure of the standard blockchain, as long as the registration is successful, each role in the chain will have permanent data access rights, and the flexibility of access control is poor. Therefore, this study proposes a digital media subscription mechanism based on the Hyperledger blockchain architecture combined with proxy re-encryption. We use symmetric and asymmetric cryptography, smart contracts, and algorithms to design our protocol. When the licensee violates the agreement with the creator, the creator can revoke the access rights to the digital media of the licensee at any time, to realize more secure and convenient digital media transmission. The proposed scheme meets various security requirements of blockchain architecture, and we have also applied the BAN logic proof model to evaluate the correctness of the proposed scheme. This study also proposes an arbitration mechanism when the dispute occurs, and performed well in terms of communication and computational costs.
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López A, Escobar MF, Urbano A, Alarcón J, Libreros-Peña L, Martinez-Ruiz DM, Casas LÁ. Experience with Obese Patients Followed via Telemedicine in a Latin American Tertiary Care Medical Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912406. [PMID: 36231703 PMCID: PMC9564633 DOI: 10.3390/ijerph191912406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND Obesity is a major public health concern worldwide. Latin America has experienced rapid growth in obesity incidence during the last few decades. Driven by confinement measures, a telemedicine program was implemented in March 2020 to give continuity to obese patients' care through a weight loss program led by the endocrinology department in a tertiary care medical center in Latin America. OBJECTIVE This study aimed to describe the clinical experience of using digital health for monitoring and attention of obese patients and description of weight change outcomes of these patients followed via telemedicine during March 2020-December 2020. METHODS A retrospective cohort study was conducted including 202 patients. A Skillings-Mack test was performed to conduct a subgroup analysis of the medians of the weight over the follow-up period, and a mixed multiple linear regression model was performed to estimate the expected average change in weight over time Results: We observed good adherence to the program, represented by a weight loss of -4.1 kg at three months of follow-up, which was maintained even during the sixth month of follow-up. CONCLUSIONS Digital Health strategies such as telemedicine can be a helpful tool for both patients and health care providers to support the continuity of care and showing satisfactory results in the management of obese patients.
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Affiliation(s)
- Alejandro López
- Department of Endocrinology, Fundación Valle del Lili, Cali 760032, Colombia
| | - Maria Fernanda Escobar
- Department of Telemedicine, Fundación Valle del Lili, Cali 760032, Colombia
- Department of Gynecology and Obstetrics, Universidad Icesi, Cali 760031, Colombia
- Correspondence:
| | - Alejandra Urbano
- Department of Endocrinology, Fundación Valle del Lili, Cali 760032, Colombia
| | - Juliana Alarcón
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali 760032, Colombia
| | - Laura Libreros-Peña
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali 760032, Colombia
| | | | - Luz Ángela Casas
- Department of Endocrinology, Fundación Valle del Lili, Cali 760032, Colombia
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Wagner DE, Seneres G, Jones E, Brodersen KA, Whitsitt-Paulson S. Swap Up Your Meal: A Mass Media Nutrition Education Campaign for Oklahoma Teens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10110. [PMID: 36011746 PMCID: PMC9408208 DOI: 10.3390/ijerph191610110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/06/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
To address a statewide need for obesity prevention, the Oklahoma Tobacco Settlement Endowment Trust launched Swap Up in 2021, a mass media nutrition education effort for teens, ages 13-18. Swap Up utilizes the SAVI messaging approach, an audience-centric message development framework that recognizes barriers to healthy living and offers realistic solutions. Five months into the campaign, an online survey was conducted (n = 200) to assess short-term program goals related to campaign delivery, engagement, and relevance. A secondary, long-term goal related to documenting and understanding self-reported changes in past month nutrition-related behaviors was also explored. A majority of participants (72%) reported aided awareness of the campaign brand logo/advertisements, and awareness (83%) of at least one main message. Nearly half (44%) of the participants reported at least one engagement with digital media. Main message recognition, perceived relevance, and self-reported nutritional behaviors were consistently highest among those reporting both campaign awareness and digital engagement. Ultimately, Swap Up reached and delivered nutrition education messages to Oklahoma teens within the first year of launch, as intended, and was associated with self-reported changes in recent behavior. This study provides evidence that SAVI offers a promising approach for nutrition education, and underscores why digital and social media engagement strategies are critical for mass media teen behavior change campaigns. Campaign implementation and evaluation are ongoing.
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Affiliation(s)
- Dana E. Wagner
- Rescue Agency, PBC, 2437 Morena Blvd, San Diego, CA 92110, USA
| | | | - Elisabeth Jones
- Rescue Agency, PBC, 2437 Morena Blvd, San Diego, CA 92110, USA
| | - Kelli A. Brodersen
- Oklahoma Tobacco Settlement Endowment Trust, 2800 N. Lincoln, Ste 202, Oklahoma City, OK 73105, USA
| | - Sjonna Whitsitt-Paulson
- Oklahoma Tobacco Settlement Endowment Trust, 2800 N. Lincoln, Ste 202, Oklahoma City, OK 73105, USA
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